Diagnostic accuracy of ELISA in sporotrichosis: A systematic review and meta-analysis.

BACKGROUND

Sporotrichosis is a subcutaneous mycosis caused by the traumatic inoculation of dimorphic fungi from the genus Sporothrix. Traditional diagnostic methods, including direct microscopy and fungal culture, are time-consuming, require specialized expertise, and may yield false-negative results.

AIMS: This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of the enzyme-linked immunosorbent assay (ELISA) technique in detecting sporotrichosis in humans and animals.

METHODS

A comprehensive literature search was conducted across PubMed, LILACS, EMBASE, Scopus, Web of Science, ScienceDirect, CAPES Periodicals, and the Cochrane Library using both free-text terms and MeSH descriptors. The methodological quality of the studies included was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity were estimated using a random-effects model. Secondary outcomes included the positive and negative likelihood ratios and the diagnostic odds ratio (DOR).

RESULTS

Twelve studies met the inclusion criteria, comprising 1612 samples (1350 human and 262 feline). ELISA demonstrated a pooled sensitivity of 91% (95% CI: 85-94) and specificity of 90% (95% CI: 86-93), with a DOR of 94.2 (95% CI: 46.9-189.1). Subgroup analysis revealed higher diagnostic performance in feline samples, particularly when crude antigen extracts and combined fungal forms were used.

CONCLUSIONS

ELISA exhibits high diagnostic accuracy for sporotrichosis in both human and veterinary contexts. Its performance, especially in feline hosts, supports its potential role as a reliable diagnostic alternative to conventional methods.